Clinico-Biochemical Profiles and Outcomes in Acute Decompensated Heart Failure

Area of Science:

• Cardiology
• Internal Medicine
• Clinical Research

Background:

• Acute decompensated heart failure (ADHF) presents a growing global health challenge, particularly in India, with high mortality and hospitalization rates.
• Understanding the distinct characteristics of ADHF based on ejection fraction (EF) is crucial for effective patient management.

Purpose of the Study:

• To compare risk factors, clinical and biochemical profiles, and in-hospital outcomes of ADHF patients with preserved versus reduced ejection fraction (EF) in an Indian population.
• To address a significant gap in Indian data regarding ADHF patient characteristics and outcomes.

Main Methods:

• A cross-sectional observational study involving 100 consecutive adult patients diagnosed with ADHF.
• Exclusion criteria included congenital heart disease, chronic cor pulmonale, and rheumatic heart disease.
• Data collection included detailed history, clinical examination, investigations, and follow-up until discharge or death, analyzed using SPSS v26.0.

Main Results:

• The study population comprised 52% with heart failure with reduced ejection fraction (HFrEF) and 48% with heart failure with preserved ejection fraction (HFpEF), with a mean age of 62.3 years and male predominance.
• Hypertension, obesity, and COPD were more prevalent in the HFpEF group, while anemia and sepsis were common precipitating factors.
• Elevated total leukocyte count (TLC), N-terminal pro-B-type natriuretic peptide (NT-proBNP), serum creatinine, and shock were associated with poorer outcomes, with creatinine being a strong mortality predictor.

Conclusions:

• ADHF patients exhibit diverse clinico-biochemical profiles and a high comorbidity burden, with notable differences between preserved and reduced EF groups.
• In-hospital mortality rates did not significantly differ between the two EF groups.
• Comprehensive risk assessment beyond EF is essential for timely and individualized management strategies in ADHF.